This article is more than 5 years old. Information may no longer be current.
Rules for salvaging the doctor-patient relationship
Click Here to Manage Email Alerts
At the American Academy of Ophthalmology’s Refractive Subspecialty Day, a group of refractive surgeons held a session where physician experts squared off against each other, one playing doctor and one playing patient, to act out the drama that can happen when patients perceive a less-than-desired outcome after surgery. Although each of us has his or her own style for communicating, several rules for maintaining the doctor-patient relationship emerged that are worth remembering:
Don’t ever say, “I told you so”
After surgery, if a patient develops a problem that was included in the preoperative discussion, tread very gently if you choose to remind the patient that you had foretold this consequence. It frequently sounds like the most unwelcome, “I told you so.”
Always take the patient’s side
Use phrases like, “Here’s what I recommend we do.” Use body language, like sitting slightly below the patient’s level and sitting beside the patient while you both face the patient chart or other family members in the room. This subtle physical message puts you on the same team. When offering next steps in treatment, it’s good to offer two options while clearly stating the one that you prefer. This tells the patient that you are thoughtful enough to consider various treatment options but experienced enough to recommend a best course.
Be honest, but give other doctors the benefit of the doubt
A patient who is coming to you for a second opinion will tend to magnify anything disparaging you say about their first doctor. Make sure you describe that doctor’s care with the same fairness that you yourself would ask for. If a surgical complication happened, don’t hide it, but focus on solutions rather than blame.
Be a friend
As with all patients, setting a tone of friendly collaboration will engender trust and confidence. Speak in your normal, friendly tone, rather than the louder, slower, more deliberate speech pattern we use when we are on the defensive. Smile warmly and let your feelings guide your actions to treat your patient as a friend who needs your help, rather than an adversary. Run toward your most challenging patients, rather than away, as human nature would otherwise dictate.
I hope these tips are helpful to you as you continue to learn how to better take care of patients — as we all do throughout our careers.
I’m very grateful to the faculty who led our “interactive consultations” session: Sonia H. Yoo, MD; A. John Kanellopoulos, MD; Jack T. Holladay, MD, MSEE, FACS; Helen Wu, MD; Kendall Donaldson, MD; Karl Stonecipher, MD; Carlos Buznego, MD; Audrey Talley-Rostov, MD; Eric D. Donnenfeld, MD; Kerry D. Solomon, MD; and Jeffrey Machat, MD.
I also welcome your comments and thoughts on how to best address the care of challenging patients.